Kelsey Jepsen, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

95021529 Issued in CA

Practice address

11100 Warner Ave Ste 368
Fountain Valley, CA 92708-7514

Phone

(714) 410-1025

NPI assigned

Jul 7, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1508599424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8578 AMAZON RIVER CIR",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085510",
            "telephone_number": "818-319-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE STE 368",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087514",
            "telephone_number": "714-410-1025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEPSEN",
        "first_name": "KELSEY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95021529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay S.H. Masserman, M.D., Inc.
• Garrett Michael Jay
• Mark Jaynes
• JBS Pacific, Inc
• Jenni Nguyen & Christopher Nguyen, D.D.S,Inc.
• Bailey T. Jewett, D.C.
• Haresh S. Jhangiani, M.D.
• Jihyun Ro
• Gabrielle Michelle Jimmerson, APCC
• Jin Jou Lu MD

• Pediatric Nurse Practitioner in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Pediatric Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.